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A patient will be eligible for inclusion in this study if all of the following criteria apply:
  1. Patients diagnosed within the previous three years with one of the following:
    1. High count monoclonal B-cell lymphocytosis (MBL) i.e. clonal B-cell population 0.5-4.9 109/L,
    2. Rai Stage 0-2/ Binet Stage A or Stage B Chronic Lymphocytic Leukaemia not meeting the IWCLL criteria for treatment
    3. IgG or IgA Monoclonal Gammopathy of Uncertain Significance meeting one of the following criteria:
          1. IgA paraprotein > 10g/L or
          2. IgG paraprotein >15g/L or
          3. IgA/IgG paraprotein below these cut-offs but kappa: lambda light chain ratio of                                              - <0.1 to >3.0 (For OUH participants or sites with no pre-defined cut offs for high risk MGUS) or             - within the cut off criteria of the local laboratory ranges for high risk MGUS
          4. Patients not meeting the cut-offs defined in points i) to iii) but who are referred to secondary care e.g. due to GP concern or for investigation of symptoms
d. IgM Monoclonal Gammopathy of Uncertain Significance meeting one of the following criteria:
i. IgM paraprotein > 10g/L or
ii. IgM paraprotein <10g/L and difference between the kappa and lambda light chains of > 50mg/L
iii. Patients not meeting the cut-offs defined in point i) and ii) but who are referred to secondary care e.g. due to GP concern or for investigation of symptoms
e. Asymptomatic smouldering Waldenström's Macroglobulinaemia not meeting the criteria for treatment
f. Smouldering myeloma not meeting the criteria for treatment
2.    ECOG performance status of 0, 1 or 2
3.    Age 16 years and over
4.    Signed written informed consent
5.   The patient is willing and able to comply with the protocol for the duration of the study, and scheduled follow-up  visits and examinations.